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Applicants must complete all sections, provide general information and licensure details, list administrative endorsements with registration dates and regions, and answer experience questions with verification letters. The form also covers academic requirements, including master’s degree universities and verification of graduate-level professional education hours, and warns that incomplete or insufficient documentation can delay processing.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/request-for-a-certificate-of-qualification-isbe-21-04/533751/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/request-for-a-certificate-of-qualification-isbe-21-04/533751.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What must applicants complete to qualify for regional superintendent office?","Question",{"text":112,"@type":113},"Applicants must complete every section of the qualification request form, including general information, licensure information, experience requirements, and academic requirements.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How should applicants provide evidence of teaching or administrative experience?",{"text":117,"@type":113},"Applicants must answer each experience question with “Yes” or “No” and include letters of experience from relevant employers for verification.",{"name":119,"@type":110,"acceptedAnswer":120},"What academic documents or details are required?",{"text":121,"@type":113},"Applicants must provide the university(ies) where they earned a master’s degree and submit official master’s or graduate transcripts for verification if they are not listed on the ELIS profile, plus confirm at least 20 semester hours of graduate-level professional education coursework.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},533751,1791688801,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","1100 North First Street, E-240 Springfield, Illinois 62777-0001  \n21-04  \nREQUEST FOR A CERTIFICATE OF QUALIFICATION TO HOLD OFFICE AS A REGIONAL SUPERINTENDENT OF SCHOOLS  \nEDUCATOR EFFECTIVENESS DEPARTMENT  \nDirections: In order to qualify to hold office as a regional superintendent of schools, an individual must first obtain a certificate of qualification from the State Superintendent of Education [see 105 ILCS 5/3-1] . Individuals seeking a certificate of qualification should use this form. Please complete each section of this document in its entirety and send to the address at the top of the page. Note that incomplete requests or requests with insufficient supporting documentation may be delayed. Individuals seeking a certificate of qualification should use this form. Please complete each section of this document in its entirety and send to the address at the top of the page or to akerske@isbe. net and [ebelcher@isbe.net](ebelcher@isbe.net).  \nI. General Information. Please complete all information requested in its entirety.  \n\n| NAME (Last, First, MIddle Initial) | ILLINOIS EDUCATOR IDENTIFICATION NUMBER (IEIN) |  |\n| --- | --- | --- |\n| ADDRESS (Street, City, State, ZIP Code) | HOME PHONE (Include Area Code) | BUSINESS PHONE (Include Area Code) |\n|  | EMAIL |  |\n| EDUCATIONAL SERVICE REGION | CURRENT REGIONAL SUPERINTENDENT |  |\n\nII. Licensure Information. Please list each administrative endorsement you hold, along with the current registration date and region of registration.  \n\n| ADMINISTRATIVE ENDORSEMENT | REGISTERED THROUGH | REGION OF REGISTRATION |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n\nIII. Experience Requirements. Please answer “Yes” or “No” to each question in this section and provide letters of experience from relevant employer(s) for verification.  \n Yes  No Do you have at least four (4) years experience in teaching?  \n Yes  No Have you 1) been employed in at least two of the last four years as a full-time teacher in the common public schools in Illinois; OR 2) been engaged in at least two of the last four years as a full-time administrator or supervisor in the common public schools in Illinois (include experience as an assistant regional superintendent); OR 3) served at least two of the last four years as the regional superintendent of schools in a regional office of education in Illinois; OR 4) served or been employed in a combination of any or all of these in at least two of the last four years?  \nNote: Experience outside the State of Illinois and private school experience may not be counted.  \nIV. Academic Requirements. Please complete this section in its entirety. If your master’s or other graduate transcripts are not listed on your Educator Licensure Information System (ELIS) profile, please submit official transcripts for verification.  \nFrom what university(ies) do you hold a master’s degree?  \n1)    \n2)    \n3)    \n Yes  No Do you have at least twenty (20) semester hours of professional education coursework at the graduate level?  \nI understand that requests with insufficient supplemental documentation or incomplete requests will be delayed.  \nDate Digital or Original Signature of Applicant  \nISBE 21-04 (10/25)  \nSubmit via Email","cbCaipnkNVUVQZ39","https://ap.wps.com/l/cbCaipnkNVUVQZ39","pdf",244470,"English","# General Information\n# Licensure Information\n# Experience Requirements\n# Academic Requirements","[{\"question\":\"What must applicants complete to qualify for regional superintendent office?\",\"answer\":\"Applicants must complete every section of the qualification request form, including general information, licensure information, experience requirements, and academic requirements.\"},{\"question\":\"How should applicants provide evidence of teaching or administrative experience?\",\"answer\":\"Applicants must answer each experience question with “Yes” or “No” and include letters of experience from relevant employers for verification.\"},{\"question\":\"What academic documents or details are required?\",\"answer\":\"Applicants must provide the university(ies) where they earned a master’s degree and submit official master’s or graduate transcripts for verification if they are not listed on the ELIS profile, plus confirm at least 20 semester hours of graduate-level professional education coursework.\"}]","Request for a Certificate of Qualification - ISBE 21-04 | PDF",1791596985]